Predisposing Factors:
* Genetics (Japanese heritage are more affected)
* Race (blacks are affected slightly more than whites)
* Gender (males are affected more than females 1.6:1)
infection occurs
altered immune function occurs
increase in antibody production
creates circulating immune (antibody-antigen) complexes
bind to the vascular endothelium
cause inflammation
Pericarditis Myocarditis coronary arteries dilate
Coronary Artery Aneursyms
causes blood to swirl scar tissue will begin
to form overtime
formation of Coronary
Artery Thrombosis blood vessel will heal
but not completely normal
blockage of vessel
scarring can lead to
narrowing of blood vessel
Heart Attack
Precipitating Factors:
* Virus
blood vessels, mucus membranes
and lymph nosed in the body
become inflamed
increase in size
rupture of arteries
Signs & Symptoms:
* fever for 5 days or more
* bilateral congestion of ocular
* changes in mucous membran
respiratory tract such as redden
fissured lips; or protuberance o
("strawberry toungue")
* changes in the peripheral ext
edema, peripheral erythma, des
soles
* rash, primarily truncal and po
(cervival lymph node swelling
Laboratory Findings:
* blood tests show a high WBC
a high level of protein in the bl
mild anemia
* erythrocyte sedimentation ra
and may persist for 4-6 weeks
 * urine may show the presence
Sudden Death abnormally high level of protei

Laboratory Findings: Possible Nursing Dx:

* chest x-ray may show enlargement of the heart * Risk for decreased cardiac output: structural
(cardiomegaly) changes/ inflammation of coronary arteries and
* an electrocardiogram may show changes in alterations in rate/rhythm or conduction
heartbeat rhythm
* echocardiograms during the course of illness must
be taken Nursing Management:
* Observe for signs of heart failure such as
tachycardia, dyspnea, rales, and edema
* Be alert for chest pain, arrhythmias, and ECG
changes the child might be developing myocarditis

LEGEND:
Complications
Signs & Symptoms
Laboratory Findngs
Possible Nursing Dx
Nursing Management
ns & Symptoms:
ver for 5 days or more
lateral congestion of ocular conjunctivae
hanges in mucous membranes of the upper
iratory tract such as reddened pharynx; red, dry,
ured lips; or protuberance of toungue papillae
rawberry toungue")
hanges in the peripheral extremities such as peripheral
ma, peripheral erythma, desquamation of palms and
sh, primarily truncal and polymorphous lymphadenopathy
vival lymph node swelling (one lymph node > 1.5 cm)
oratory Findings:
ood tests show a high WBC count, high platelet count,
gh level of protein in the blood serum, and
d anemia
ythrocyte sedimentation rate (ESR) elevated
may persist for 4-6 weeks
Possible Nursing Dx:
* Pain r/t swelling of lymph nodes
and inflammation of joints
* Risk for ineffective peripheral tissue
perfusion r/t inflammation of blood vessels
* Hyperthermia r/t increased metabolic
rate and dehydration
* Impaired skin integrity r/t inflammatory
process as evidenced by macular rash
and desquamation
*Impaired oral mucous membrane r/t
inflammatory process, dehydration, and mouth
breathing as evidenced by pain, hyperemia,
and fissured lips
Nursing Management:
* Monitor vital signs specially the temperature
* Check for blood pressure
* Inspect extremities for color
* Palpate for warmth and capillary filling in toes and
fingers to evaluate peripheral tissue perfusion
ine may show the presence of pus or an
ormally high level of protein
* Carefully monitor and record the intake and output
* Encourage the child to continue brushing his or
her teeth
* Observe for signs of gastrointestinal obstruction,
such as vomiting
* To minimize skin discomfort, cool cloths,
unscented lotions, and soft, loose clothing are helpful
* During the acute phase, mouth care, including, applying
lubricating ointment to the lips, is important, for the
mucosal inflammation